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UPJ INSIGHT Perception of Physician Reimbursement by Medicare for Artificial Urinary Sphincter Placement

By: Robert J. Pearce, MD; University of California, San Francisco, Charles P. Jones, MD; Washington University St Louis, Missouri, Sultan Al Azzawi; University of California, San Francisco , Kevin D. Li; University of California, San Francisco, Umar Ghaffar, MD; University of California, San Francisco, Behzad Abbasi, MD; University of California, San Francisco, Nizar Hakam, MD; University of California, San Francisco , Natalie Rios; University of California, San Francisco , Hiren V. Patel, MD; University of California, San Francisco , Benjamin N. Breyer, MD, MAS; University of California, San Francisco | Posted on: 17 Jul 2024

Pearce RJ, Jones CP, Al Azzawi S, et al. Patient perception of physician reimbursement by medicare for artificial urinary sphincter placement. Urol Pract. 2024;11(4):678-683. doi:10.1097/UPJ.0000000000000575

Study Need and Importance

Patient perceptions of physician reimbursement for urologic procedures are unknown; however, understanding these perceptions is essential for maintaining trust in the patient-physician relationship and informing health care policy decisions. This study specifically focuses on patient perceptions of reimbursement for artificial urinary sphincter placement, a common procedure for incontinence among Medicare patients.

What We Found

We surveyed Medicare recipients who had undergone artificial urinary sphincter surgery and found that patients overestimated reimbursement by approximately 25 times. Most reported that the urologist compensation was much lower than they considered fair (Figure). The surveys also revealed that most patients thought their urologist was overpaid prior to learning the true reimbursement.

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Figure. Perception of urologist reimbursement for artificial urinary sphincter by Medicare.

Limitations

While the study provides valuable insights, it is limited by its single-institution focus and relatively homogeneous patient cohort. Future research could involve multi-institutional cohorts and aim to include a more diverse range of participants in multiple geographic regions and in multiple languages.

Interpretation for Patient Care

This study underscores the importance of recognizing and addressing the significant disparity between patient perceptions and actual physician reimbursement. Patients may be more trusting of their urologist and receptive to treatment recommendations if they have a realistic understanding of incentives. Additionally, health care policymakers should consider patient perspectives when making decisions about health care policy and reimbursement rates, aiming to increase transparency and accessibility in the health care system overall.

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